Anticoagulant (AVK) and antibiotic drug interactions in community practice

Aim

Anticoagulants (AVK) are frequently responsible for iatrogenic accidents leading to hospitalisation. Antibiotics (ATB) are likely to interact with AVK. The aim of this study was to assess if Loire region practitioners complied with the French agency for the safety of health products (AFSSAPS) recommendations for AVK/ATB association.

Method

Two strategies were implemented: a retrospective study of the 2007 Loire region General health insurance data on a population exposed to a single AVK split in two groups, exposed or not to antibiotics; a focus-group of practitioners from the Maine et Loire subdivision.

Results

Blood tests were not always performed. The proportion of blood tests per month was significantly more frequent in the AVK/ATB group than in the group “not exposed” to antibiotics. GPs did not implement this recommendation, which doesn’t correspond to their behaviour, as analysed by a focus-group, and to the low incidence of hospitalisations due to AVK/ATB interaction.

Conclusion

Loire region practitioners do not follow AFSSAPS recommendations. AVK/ATB interaction must be a GP's constant concern whether responsible or not for initiating AVK.